Moderate Drinking: How Much Alcohol is Too Much?

In new research that provides yet another reason to raise a glass to toast your health, two large studies — one covering 52 countries and the other from Scandinavia — have linked low-to-moderate alcohol consumption with a greatly reduced risk of heart attack or a life-threatening flaw in the main cardiac artery.

While it’s not clear whether all types of alcohol offer the same benefits to everyone — women should generally drink less than men, and some at risk for breast cancer should limit alcohol consumption altogether — the findings suggest adult beverages are a heart-healthy indulgence that may help most people combat cardiovascular disease, the nation’s No. 1 killer.

Renowned cardiologist Chauncey Crandall, M.D., says the new research is promising on the benefits of alcohol, but notes that the findings are not a license to drink to excess, even occasionally.

“We now know based on [these] studies that alcohol has benefits. It can decrease the clotting factor of the blood by decreasing platelets and a chemical called fibrinogen and it also elevates good cholesterol, called HDL, so these three things together reduce the incidence of heart disease because of alcohol use,” Dr. Crandall tells Newsmax Health. “The American Cancer Society [and American Heart Association] says that women can limit themselves to one drink a day, and men two — that is the maximum. [But] I would recommend one drink every other day.”

Dr. Crandall — chief of the cardiac transplant program at the world-renowned Palm Beach Cardiovascular Clinic in Palm Beach Gardens, Fla, and author of the Heart Health Report — adds that although the new research examined the impacts of all types of alcohol, wine and beer also contain other heart-healthy compounds that may partly account for their beneficial properties.

“Red wine in particular has high antioxidants [so] it would be my first choice,” he explains.

One of the two new studies examined the effects of drinking on the risk of experiencing an abdominal aortic aneurysm (AAA), a “ballooning” of the main blood vessel from the heart that delivers blood to the trunk and lower body.

The condition kills about 11,000 Americans each year and contributes to the death of 17,000 more, according to the Centers for Disease Control and Prevention. Men, especially those over age 60, are most likely to have AAA. Smoking and high blood pressure can increase the risk, and if the aneurysm ruptures, it can be life threatening. Heart attacks, which strike 1.5 million Americans each year, are also linked to many of the same risk factors and also can be life threatening.

For the AAA study, researchers combined two Swedish data sets with a total of 70,000 men and women over age 45 who were followed from 1998 to 2011. Their alcohol consumption was reported in food frequency questionnaires, and the incidence of AAA was cross-referenced with Swedish Health Registries. Over the 14-year period, 1020 men and 194 women were diagnosed with AAA.

Drinking four to six glasses of alcohol per week was associated with a 20 percent lower risk of AAA for men and a 44 percent lower risk for women, compared to drinking less than one or two glasses per week.

The risk kept decreasing up to the point of consuming 10 glasses per week for men and five for women. Among specific alcohols, beer and wine in particular were associated with lower risk. Although moderate alcohol use has been associated with many cardiovascular diseases, this is the first time a study has specifically identified an association with AAA.

For the heart attack study, researchers analyzed data from 52 countries to compare 12,000 cases of first heart attacks with 15,500 similar people who did not have a heart attack. Trained staff surveyed heart attack victims and the comparison group.

Compared to not drinking at all, alcohol use was linked to a 13 percent lower risk of heart attack, on average. But the protective effects went away when alcohol consumption increased beyond four drinks per week. Having six or more drinks in a 24-hour period was associated with a 40 percent increased risk of heart attack, especially for people over age 65.

“There is now solid evidence that alcohol, when consumed on a regular basis and at low volumes (up to one drink for women and two drinks for men daily), confers protection against cardiovascular disease, whereas regular amounts of more than four to five drinks daily and heavy episodic drinking have (the) opposite effects,” write Drs. Stefan Kiechl and Johann Willeit, neurologists at Innsbruck Medical University in Austria, in an editorial in the journal Circulation.

Dr. Crandall, author of “The Simple Heart Cure,” adds that drinking isn’t the only way to reduce the risk of developing heart disease. It’s also important to eat a healthy diet, exercise daily, lose excess weight, reduce stress and eliminate any tobacco use.

“It’s not that I’m recommending alcohol, there are other things that we can do to improve our risk against heart disease, but the studies do tell us that possibly a drink every other day will give benefit in reducing [heart disease], but more than four to six drinks a week has no benefit,” he says.

“The main thing is eating well. That is the No. 1 thing that will reduce heart disease. So eating a plant-based diet, with the addition of possibly cold water fish and poultry would be No. 1. The second would be exercising an hour a day. I think that is very important, and walking is a great exercise for one hour.

“The third would be maintaining ideal body weight, that’s very important. And fourth, of course, stopping [smoking] cigarettes and lowering our stress is very important for these people to reduce the risk of heart disease.”

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